‘I want to do it myself’

That pesky rash on your baby’s bottom is a lot more complex than it looks. We explore the different types of nappy rash and how to treat them

JUST ABOUT EVERY baby gets nappy rash at some time – it’s normal. Remember that babies have very sensitive skin. Add to that the fact that it is moist inside the nappy, and wee and poo contain various chemicals that can irritate the skin, and the rubbing of the nappy itself can also irritate your baby’s skin. It’s no wonder, then, that the area is prone to occasional skin problems. Keep the area clean and dry and follow these basic suggestions to minimise itchy bum issues. Your baby will hopefully have no more than the occasional mild nappy rash: ✓ Change nappies frequently, particularly after your baby has made a poo. Wipe well to get rid of all residue. Plain water is fine, or use wipes that are alcohol- and fragrance-free. Then dry the area well before putting on a new nappy. ✓ Fit the nappy comfortably, snugly and evenly, so it doesn’t rub, gape or pinch. Apply a bum cream, which forms a barrier between your baby’s skin and urine in the nappy.

Petroleum ointment (Vaseline) is a popular everyday preventative ointment, as it’s not sticky or messy. White zinc oxide is thicker and stickier, which may be helpful for babies who are prone to rashes. ✓ Corn starch, an old home remedy, is generally not recommended for use on baby’s bum, as it may encourage a fungal growth. The important thing is to maintain the health of the skin in the nappy area with an effective cream.

MILD NAPPY RASH

No matter how clean and dry you try to keep your baby’s bum, nappy rash flareups do occur. When you spot the first sign of nappy rash, take steps to soothe and heal the skin.

Gently wash the area – don’t rub, just use a squirty bottle, a jug or a syringe of water to wash away any wee or poo residue. Gently pat dry without rubbing. It is very helpful to let the area dry thoroughly.

If you can, leave your baby on her tummy without a nappy or bum cream on, and let her bottom be exposed to the air for a while. Do this a few times a day to help air things out.

This way you’re getting some tummy time in while helping to prevent rashes. Don’t forget to put a towel or a mat down first to avoid messy accidents!

There are many different ointments for nappy rash. A good over-the-counter ointment should be sufficient for a normal, mild nappy rash. It is a good idea to ask your pharmacist or your clinic sister for a recommendation.

RECOGNISE THE PROBLEM RASHES

A mild nappy rash can be uncomfortable, but it should disappear quickly with treatment.

Complications may occur when the skin, which has already been damaged due to the rash, is now invaded by bacteria or yeast. That’s when the rash tends to worsen and may not be quite so easy to get rid of.

When it comes to these more stubborn and worrying nappy rashes, it’s important to realise that not all of them are the same.

There are a number of different causes, and, depending on the cause, different treatments. There are subtle differences that enable you to recognise what sort of rash you are dealing with, so that you can use the right product for that particular condition.

HERE IS A GUIDE TO SOME OF THE COMMON NAPPY RASHES, WHAT THEY ARE CAUSED BY, AND HOW TO TREAT THEM.

Contact nappy rash is the common, mild rash referred to above. What to look for: Flat, red, irritated skin. When the rash is severe, skin will peel or blister and slough off. Treatment: Keep the area clean, dry well and apply a nappy rash cream.

Intertrigo is a rash that occurs within the skin folds around your baby’s nappy area where the skin rubs together. What to look for: The rash has a red, burn-like appearance in the creases. Treatment: Regular white petroleumbased ointment. Yeast rash is also known as thrush or candida and it occurs when fungal particles invade broken skin. It is most common after a baby has had antibiotics, or when a hard-to-treat rash has gone on for a long time. What to look for: A red, raised, patchy rash with distinct borders, mostly over the genitalia but with satellite spots sprinkled around the nappy area. This rash starts as small red spots that become more numerous and then join together. This rash can make the skin quite tender, and your baby might be feeling unwell. Treatment: An antifungal remedy is required. There are treatments available over the counter or they can be prescribed by your doctor. Apply the cream as directed, usually two to three times a day, and then cover with your usual bum cream.

A natural option is acidophilus powder, which acts against yeast infections.

If you are breastfeeding and your baby has thrush, you will need to treat yourself, too. Often what happens is that the fungal infection is passed back and forth between mom’s nipple to baby’s mouth. Both need treatment in order to get rid of the infection entirely.

Impetigo occurs when particular bacteria (streptococci or staphylococci) invade the broken skin. It is quite aggressive and can progress rapidly, spreading elsewhere on the body, sometimes even leaving scars if untreated.

What to look for: Blisters or red, raised patches that ooze a honey-coloured crust. Treatment: See your doctor as soon as possible for a diagnosis. He or she will prescribe either an antibiotic cream or oral antibiotic.

Seborrhoea is an inflammatory skin condition that can affect any part of the body, but can be severe in the nappy area. What to look for: A big, red, sharply demarcated patch over the groin, genitalia, and lower abdomen. It may be more raised, rough, thick, and greasy than the other rashes and may develop yellowish scales. Treatment: Hydrocortisone one percent cream is very effective for inflammation. It should be applied twice daily, but should not be used for more than a week as it can damage the skin.

An allergy ring may be brought on by certain foods that irritate your baby’s bottom when they come out in her poo. Acidic foods such as citrus and tomatobased sauces are often the culprit. Despite what you might have heard, ordinary nappy rash is not generally related to food allergies, so don’t start restricting foods just in case. Rather consult your doctor. What to look for: A red ring around baby’s anus. Treatment: Discontinue any acidic foods that you suspect may play a role. Breastfeeding moms may need to eliminate foods from their diet, although this condition is rare in breastfed babies, occurring more commonly in bottlefed babies and once solids have been introduced. YB

Nappy rash is very common and is seldom cause for alarm. However, if the nappy rash is very persistent and resists regular treatment, you should see your doctor.

Chances are, there is a bacterial or fungal infection, in which case a doctor’s diagnosis and a prescription will be necessary.

These conditions can also be painful and make your baby unhappy. If your baby shows other symptoms, such as fever or restlessness, or if the rash is present elsewhere on the body, consult your doctor.